Procaine, vitamin H3, is known only as a local anesthetic,
The use of procaine as a vitamin, nutrient, and regenerant has only begun in recent decades.
Excessive manifestations [1]
Overreaction to local anesthesia is usually associated with high blood drug concentration or accidental subarachnoid injection during local anesthesia.
Recent clinical data indicate that hypoxia, carbon dioxide retention, and acidosis can develop rapidly in patients with convulsions caused by an overdose of local anesthesia within one minute of the onset of convulsions.
Oxygen and carbon dioxide retention and acidosis convulsions without immediate treatment, combined with direct inhibition of the myocardium caused by the effect of local anesthesia, can lead to fatal adverse reactions such as arrhythmias, bradycardia, cardiac arrest or ventricular fibrillation or cardiac arrest in patients with respiratory system abnormalities, including apnea.
Accidental injection of local anesthetics into the subarachnoid space may result in inadequate ventilation or apnea, or cardiac arrest if respiratory support is not established in time.
Treatment options [1]
Prevention should be considered first.
After procaine administration, patients' vital signs should be continuously monitored after each local anesthesia injection, and patients' consciousness state should be confirmed in time.
If the patient's condition changes, oxygen should be provided in time.
For systemic toxicity, hypoventilation, or apnea caused by an accidental subarachnoid injection, the first step should be to immediately establish or maintain an open airway and provide positive pressure oxygen through a mask to prevent convulsions.
Medications may be used to control convulsions if necessary.
Intravenous succinylcholine (50mg-100mg) paralyzes the patient, maintains ventilation, and does not inhibit the central nervous and cardiovascular systems.
Intravenous injections of 5mg-10mg diazepam or 50mg-100mg sodium thiopental can promote ventilation and counteract central nervous system irritation, but these drugs can also inhibit central nervous system, respiratory and cardiac function, worsen post-attack depression and may lead to apnea.
Barbiturates, anticonvulsants or muscle relaxants may be administered intravenously, but only by those familiar with their use.
Adequate blood circulation should be assessed immediately after ventilation. Supportive treatment for patients with circulatory depression may require intravenous fluids and, depending on clinical circumstances, the use of vasopressors (e.g., ephedrine, epinephrine) to enhance myocardial contractile force.
If oxygen delivery through a mask is ineffective or prolonged respiratory support is required, medications and techniques familiar to the clinician may be used for intubation.
In the event of cardiac arrest, standard cardiopulmonary resuscitation (CPR) should be performed and extended if necessary. The patient's heart beat back after a long period of resuscitation.
Reference:
Product Information: Novocaine Hydrochloride Procaine Injection, Solution, Hospira, Inc. April 16, 2007.
